Volume 08 Issue 01 January 2025
1Danjuma Peninnah AGWAI,2 Dorothy Akpovye BAGE-JOHN, PhD
1,2Department of Sociology, Faculty of Social Sciences, Federal University of Lafia, Nasarawa State, Nigeria
DOI : https://doi.org/10.47191/ijsshr/v8-i1-07Google Scholar Download Pdf
ABSTRACT
Access to primary healthcare services is a fundamental right and a crucial determinant of overall population health. Primary healthcare represents the first point of contact for individuals seeking preventive care, diagnosis, treatment, and health education. However, the utilization of these essential services is not uniform across all segments of society, as various socio-economic factors play a significant role in influencing an individual's ability to access and effectively utilize primary healthcare services. Therefore, this study examined socio-economic factors and the utilization of primary health care services in Keffi Local Government Area of Nasarawa state, Nigeria. The study objectives were; to find out the primary health care services available for residents of Keffi LGA, to examine individuals’ income level and utilization of primary health care services and to ascertain the influence of individual level of education and utilization of primary health care services in Keffi LGA, Nasarawa state, Nigeria. The study adopted social determinants of health and behavioural theory of health care use to explain the socio-economic factors and utilization of primary healthcare services. A descriptive survey design was adopted, questionnaire and interview were used to gather data from 410 selected respondents through Multi-stage sampling technique. Hypothesis were analysed using Pearson Moment Product correlation and regression analysis with reliability of 0.5. The study found that within the study area, primary healthcare facility are available and accessible to the people. And income and educational level influencing the utilization of primary health care services. The study recommended the need to ensure adequate staffing of primary care facilities with general practitioners, nurses, and other healthcare professionals to meet the growing demand for services and the need to develop educational programs and campaigns specifically targeted at individuals with lower levels of education to increase their awareness and understanding of the importance of preventive care and timely access to primary healthcare services.
REFERENCES1) Abekah-Nkrumah, G. & Abor, P. A. (2015). Socioeconomic determinants of use of reproductive health services in Ghana. Health Economics Review (HER), 6(1), 1–15
2) Adam, V.Y. & Awunor, N.S. (2015). Perceptions and factors affecting utilization of health services in a rural community in Southern Nigeria. Journal of Biomedical Sciences 13(2), 117-124
3) Addai, I. (2018). Demographic and sociocultural factors influencing use of maternal health services in Ghana. African Journal of Reproductive Health, 2 (1), 44-89.
4) Akintola, J. O & Yusuff, J. M. (2021). Socio economic analysis of poverty levels among rural dwellers in Kwara State, Nigeria. International Journal of Environment and Development, 5(2), 42-48
5) Al-Ghanim, S. A. (2014). Factors influencing the utilisation of public and private primary health care services. Journal of King Abdulaziz University Medical Science. 19(1), 3-27.
6) American Medical Association (2019). Health literacy: Report of the council on scientific affairs. Journal of American Medical Association. JAMA. 28(1), 552–597.
7) Ardington, U. & Case, G. (2006). Health seeking behaviour of rural dwellers in Southern Nigeria: Implications for healthcare professionals. International Journal of Tropical Disease and Health, 2(2), 62-71
8) Asafo, P., Akowuah, J., Agyei-Baffour, & Awunyo-Vitor, D. (2018). Determinants of Antenatal Healthcare Utilisation by Pregnant Women in Third Trimester in Peri-Urban Ghana. Journal of Tropical Medicine, 1, 1-8
9) Awiti, J.O. (2020). Poverty and health care demand in Kenya. BMC Health Services Research. 14(3), 549-560.
10) Babalola, S. & Fatusi, A. (2019). Determinants of use of maternal health services in Nigeria: looking beyond individual and household factors. British Medical Care Pregnancy Childbirth, 9(43), 1-13.
11) Baker, D. W., Parker, R. M., Williams, M. V. & Clark, W. S. (2017). The relationship of patient reading ability to self-reported health and use of health services. America Journal of Public Health. 8(7), 1027–1040.
12) Bakeera. S.K., Wamala, S.P., Galea, S., State, A. Peterson, S. & Pariyo, G.W. (2019). Community perceptions and factors influencing utilization of health services in Uganda. International Journal for Equity in Health 8(25), 75-92.
13) Baschien, A. & Clements, S. (2020). Contextual influences on the use of health facilities for childbirth in Africa. America Journal of Public health, 96(1), 84-92.
14) Bayati, M., Akbariyan, R., Kavosi, Z. & Delavari, S. (2012). Socioeconomic determinants of health in the countries of West Pacific: analysis of panel data. Social Welfare, 12 (47), 111–30.
15) Berberoglu, U., Ozturk, O., Ekerbicer, H. C., & Grubu, B. (2018). Evaluation of the health literacy status among individuals aged 18-65 Registered in a family health centre. Sakarya Tıp Dergisi. 8(3), 575-581.
16) Berkman, N. D., Sheridan, S. L., Donahue, K. E., Halpern, D. J & Crotty, K. (2021). Low health literacy and health outcomes: An updated systematic review. Annals of Internal Medicine. 155(2), 65-97.
17) Bindman, A. B. & Osmond, D. (2015). Primary care and receipt of preventive services. Journal of General Internal Medicine. 11(5), 269–276.
18) Boyle, J., Speroff, T. & Worley, K. (2017). Low health literacy is associated with increased transitional care needs in hospitalized patients. Journal of Hospital Medical. 12(9), 18–24.
19) Brennan, L. K. & Baker. (2008). Promoting health equity: a resource to help communities address social determinants of health. Atlanta: U.S. Department of Health and Human Services, centres for disease control and prevention.
20) Brunner, E. & Marmot, M. (1999). Social organization, stress and health. In: Social determinants of health. Oxford University Press.
21) Centre for Disease Control (2022). National Health Interview Survey. Available from: https://www. Centre for Disease Control./en/nigeria/admin/ekiti/NGA013008__ido_osi/.
22) Chubike, N.E & Constance, I. (2020). Demographic characteristics of women on the utilization of maternal health services at Abakaliki Urban. International Journal Nursery Midwifery, 5(8), 139-144.
23) Chuma, J. & Okungu, V. (2018). Viewing the Uganda health system through an equity lens: implications for universal coverage. International Journal for equity in Health. 10(22), 10-22.
24) Copurlar, C. & Kartal, M. (2021). What is Health Literacy? How to measure it? Why is it important? Turkish Journal of Family Medicine and Primary Care. 10(1), 31- 40.
25) Darin‐Mattsson, A., Fors, S., & Kareholt, I. (2017). Different indicators of socioeconomic status and their relative importance as determinants of health in old age. International Journal for Equity in Health, 16(1), 134-144.
26) Department of Health & Human Services (2020). Primary healthcare explained. Retrieved from https://www.betterhealth.vic.gov.au/health/servicesandsupport/primary-healthcare-explained
27) Develay, A., Sauerborn, R., & Diesfeld, H. J. (2016). Utilization of health care in an African Urban Area: results from a household survey in Ouagadougou, Burkino-Faso. Social Science and Medicine. 43(11), 1611-1619.
28) Dhai, A. (2022). A health system that violates patients' rights to access health care: editorial. South African Journal of Bioethics and Law, 5(1), 2-3.
29) Di, M.S. (2020). What is the effectiveness of antenatal care? (Supplement) Copenhagen, WHO Regional officer for Europe: Health Evidence Network Report.
30) Ensor, T. & Cooper, S. (2019). Overcoming barriers to health service access: influencing the demand side. Health Policy and Planning, 19(2), 69-79.
31) Exworthy, M. (2008). Policy to tackle the social determinants of health: using conceptual models to understand the policy process. Health Policy Plan, 23(5), 318–27.
32) Fagbamigbe, A.F., & Idemudia, E.S. (2015). Barriers to antenatal care use in Nigeria: evidences from non-users and implications for maternal health programming. BMC Pregnancy and Childbirth, 15(1), 95
33) French, D.P., Cooper, A., & Weinman, J. (2006). Illness perceptions predict attendance at cardiac rehabilitation following acute myocardial infarction: a systematic review with meta- analysis. Journal of Psychosomatic Research, 61, 757-767.
34) Gabriel, U & Gabriel, G. (2021). The role of primary healthcare in Nigeria: a way forward. Retrieved from https://hphr.org/blog-oke-3/
35) Gakii, J. (2021). Demand for health care in Kenya: The effect of health insurance. Nairobi: Kenya Institute for Public Policy Research and Analysis.
36) Herndon, J. B., Chaney, M. & Carden, D. (2019). Health literacy and emergency department outcomes: a systematic review. Ann Emergency Medical. 57(3), 34–45.
37) Ibor, U. W., Anjorin, O.A., Ita, A.E. Otu, M.A., & Bassey, T.I. (2021). Utilization of antenatal care in Ibadan North Local Government Area, Oyo State, Nigeria. Trends in Medical Research, 6, 273-280.
38) Ibrahim, M. J. & Ibrahim, A. A. (2018). The accessibility problems of primary health care to rural people in Jigawa State, Nigeria. Global Advanced Research Journal of Social Science 1(4), 72-76.
39) Igboanusi, C., Sabitu, K., Gobir, A., Nmadu, A. G & Joshua, I. (2019). Factors affecting the utilization of postnatal care services in primary health care facilities in urban and rural settlements in Kaduna State, North-western Nigeria. American Journal of Public Health Research. 7(1), 11-17
40) Iyaniwura, C.A. & Yussuf, Q. (2019). Utilization of antenatal care and delivery services in Sagamu, South-Western Nigeria. African Journal of Reproductive Health, 13(5), 110-122.
41) Joshi, A. (2014). The Nigerian health care system: need for integrating adequate medical intelligence and surveillance systems. Journal of Pharmacy and Bioallied Sciences, 3(4), 470-478.
42) Kalichman, S.C., Catz, S. & Ramachandran, B. (2019). Barriers to HIV/AIDS treatment and treatment adherence among African-American adults with disadvantaged education. Journal of the National Medical Association, 91(8), 439-446.
43) Katung, P.Y (2019). Socio-economic factors responsible for poor utilization of primary health care services in rural community in Nigeria. Niger Journal of Medicals. 10(3), 28-29
44) Kripalani, S., Jacobson, T. A. & Mugalla, I. C. (2020). Health literacy and the quality of physician-patient communication during hospitalization in Ghana central district. Journal Hospital Medical. 5(2), 69–75.
45) Macinko, J., Starfield, B. & Erinosho, T. (2016). The impact of primary healthcare on population health in low- and middle-income countries. Journal HealthCare Manager. 32(2), 50-71.
46) Magadi, M. (2019). Maternal and child health among the urban, African Population Studies/Etude de la Population Africaine, 19(2), 179-198.
47) Mahoney, S. T., Tawfik-Sexton, D., Strassle, P.D., Farrell, T.M. & Duke, M.C. (2018). Effects of education and health literacy on postoperative hospital visits in bariatric surgery. Journal of Laparoendosc Advance Surgical. 28(7), 1100–1114.
48) Manzoor, I., Hashmi, N.R., & Mukhtar, F., (2019). Determinants and pattern of health care services utilization in postgraduate students. Journal of Ayub Medical College, 21(3), 100-105
49) Mushi, D. P. (2019). Impact of cost sharing on utilization of primary health care Services: providers versus household perspectives. Malawi Medical Journal. 23(3), 83–99.
50) Na¨slindh-Ylispangar, A., Sihvonen, M., Kekki, P. (2018). Health, utilisation of services, ‘core’ information, and reasons for non-participation: a triangulation study amongst non-respondents. Journal of Clinical Nursing, 17(2), 2-29.
51) National Population Commission (NPC) Abuja, (2021). 2021 population estimation of Federal Republic of Nigeria.
52) Ndisika, M. & Dawodu, O.A. (2019). Antenatal care service utilization among women of reproductive age in Egor Local Government Area, Benin City. Akpauche International Journal of Arts and Social Sciences, 1(2), 60-73
53) Nnonyelu, A.N & Nwankwo, I. U. (2020). Social determinants of differential access to health services across five states of Southeast Nigeria. European Scientific Journal, 5(3), 1857 – 7881
54) Okpokoro, E. (2014). Primary health care: a necessity in developing countries? Journal of Public Health in Africa. 4(2), 76–98.
55) Oladipo, J. A. (2019). Utilization of health care services in rural and urban areas: a determinant factor in planning and managing health care delivery systems. African Health Sciences, 14(2), 322–333.
56) Onwujekwe, O. & Uzochukwu, B. (2018). Socio-economic and geographic differentials in costs and payment strategies for primary health care services in south-east Nigeria. Health Policy. 71(3), 83-97.
57) Onwujekwe, O. E., Uzochukwu, B. S., Obikeze, E. N., Okoronkwo, I., Ochonma, O. G., Onoka, C. A., Okoli, C. (2022). Investigating determinants of out-of-pocket spending and strategies for coping with payments for healthcare in southeast Nigeria. BMC Health Services Research, 10(4), 10-27.
58) Otieno, S.O. & Macharia, D. (2018). Factors influencing utilization of health services in Kenya: The case of Homa Bay County. International Journal of Public Health Science. 3(4), 213-223.
59) Ousman, S.K, Mdala, I., Thorsen, V.C., Sundby, J. & Magnus, J.H. (2019). Social determinants of Antenatal Care Service Use in Ethiopia: Changes over a 15-Year Span. Front. Public Health, 7,161.
60) Oyekale, A. S. (2017). Assessment of primary health care facilities’ service readiness in Nigeria. British Health Services. 17(1), 2–12.
61) Ozdemir, H., Alper, Z., Uncu, Y. & Bilgel, N. (2021). Health literacy among adults: a study from Turkey. Health Education Research. 25(3), 464-477.
62) Paasche-Orlow, M. K., Parker, R. M., Gazmararian, J. A., Nielsen-Bohlman, L. T. & Rudd, R. R. (2015). The prevalence of limited health literacy. Journal of General Internal Medicine. 20(2), 175–84.
63) Porterfield, S.L. & McBride, T.M. (2017). The effect of poverty and caregiver education on perceived need and access to health services among children with special health care needs. American Journal of Public Health, 97(2), 323-329.
64) Primary health care (2023). Retrieved from https://www.who.int/news-room/questions-and-answers/item/primary-health-care.
65) Prosser, T. (2017). Utilization of health and medical services: Factors influencing health care seeking behaviour and unmet health needs in rural areas of Kenya. Joondalup: Edith Cowan University.
66) Raatikainen, K, Heiskanen, N & Heinonen, S. (2017). Under-attending free antenatal care is associated with adverse pregnancy outcomes in United States of America. British Medical Care Public Health Journal, 7(26), 1-18:
67) Rai, R. K, Singh, P. K. & Kumar, C. (2016). Is the use of maternal healthcare among prospective mothers higher in households that have experienced maternal death? Evidence from India. Health Policy and Planning, 31(7) 844–852
68) Saad-Haddad, G., DeJong, J., & Terreri, N. (2022). Patterns and determinants of antenatal care utilization: Analysis of national survey data in seven countdown countries. Journal of Global Health, 6(1), 16-30
69) Sadeghi, S., Brooks, D., Stagg-Peterson, S. & Goldstein, R. (2023). Growing Awareness of the Importance of Health Literacy in Individuals with COPD. Chronic obstructive pulmonary disease. 10(1), 72–89.
70) Salaudeen A. G., Musa O. I., & Belo A. A. (2021). Assessment of knowledge and implementation of reaching every ward strategy of routine immunization among service providers in north central State of Nigeria. Australian Journal of Basic and Applied Sciences, 5(4), 430–435.
71) Sarıipek, D. B., & Yenihan, B. (2019). Socioeconomic status. In Springer eBooks (pp. 1–5). https://doi.org/10.1007/978-3-319-69892-2_204-1
72) Shaikh, T.B. & Hatcher, J. (2021). Health seeking behaviour and health service utilization in China: challenging the policy makers. Journal of public health. 27(1), 49-54.
73) Shi, L. (2018). The impact of primary care: a focused review. Scientifica. 21(2), 1-22.
74) Sina, O. J., Jegede, L. Y. & Ibikunle, A. M. (2021). Socio-economic status and utilization of healthcare facilities in rural Ekiti, Nigeria. Journal of Medicine and Medical Sciences. 2 (1), 1-43.
75) Solar, O. & Irwin, A. (2010). A conceptual framework for action on the social determinants of health. Social determinants of health discussion paper 2 (Policy and Practice). Geneva: World Health Organization.
76) Sorensen, K., Pelikan, J. M., Rothlin, F., Ganahl, K., Slonska, Z. & Doyle, G. (2020). Health literacy in Europe: comparative results of the European health literacy survey (HLS-EU). European Journal of Public Health. 25(6), 1053-1058.
77) Sufiyan, I. (2020). Rainfall trend and it impact in Keffi Nasarawa State. Engineering Heritage Journal. 4 (1), 23–26.
78) Sunil, T.S., Spears, W. D., Hook, L., Castillo, J. & Torres, C. (2020). Initiation and barriers to prenatal care use among low-income women in San Antonio, Texas. Maternal and Child Health Journal, 14(1), 133-140
79) Suthar, J. (2023). Socioeconomics. Journal of Social Sciences. 2(4), 13–22.
80) Uche, E.O. (2017). Factors affecting health seeking behaviour among rural dwellers in Nigeria and its implication on rural livelihood. European Journal of Social Sciences Studies, 2(2), 74-86.
81) United Nations Population Fund (2018). UNFPA Humanitarian Response in Yemen 2018.
82) United Nations Population Fund (UNFPA) (2016). Maternal mortality update 2016: Expectation and delivery: Investing in midwives and others with midwifery skills. United Nations Population Fund, Retrievedfrom http://www.unfpa.org/webdav/site/global/shared/documents/publications/2007/mm_update06_eng.pdf.
83) Vincent, Y.A., & Adewusa, Q.A. (2018). Socio-demographic factors associated with the healthcare-seeking behaviour of heads of households in a rural community in Southern Nigeria. Sahel Medical Journal, 21(1), 31-36.
84) Watt, R. (2002). Emerging theories into the social determinants of health: implications for oral health promotion. Community Dent Oral Epidemiol, 30(4), 241–7.
85) World Health Organisation (2017). Maternal mortality in 2015: estimates developed by WHO, UNICEF, UNFPA, and the World Bank Geneva: WHO.
86) WHO (2021). Primary Health Care: Report of the International Conference on Primary Health Care, Alma-Ata, USSR; 6-12 September, 2021; Geneva: WHO.
87) World Health Organization (2019). Social determinants of health. Retrieved from https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1
88) Williams, M.V., Parker, R. M., Baker, D. W., Parikh, N. S., Pitkin, K. & Coates, W. C (2015). Inadequate functional health literacy among patients at two public hospitals. Journal of America Medical Association. 274(16), 77–82.
89) Yakar, B., Gomleksiz, M. & Pirincci, E. (2019). Health literacy levels and affecting factors of patients who applied to a university hospital polyclinic. Eurasian Journal Family Medication. 8(1), 27–35.
90) Ye, Y., Yoshida, Y. & Sakamoto, J. (2019). Factors affecting the utilization of antenatal care services among women in Kham District, Xiengkhouang province, Lao PDR. Nagoya Journal of Medical Science. 72(14), 23–33.
91) Yilmazel, G. & Cetinkaya, F. (2016). The importance of health literacy for community health. TAF Preventive Medicine Bulletin. 15(1), 45-69.
92) Zaboli, R., Malmoon, Z., Seyedjavadi, M. & Seyedin, H. (2014). Developing a conceptual model of social determinants of health inequalities: A qualitative study. Journal of Health Policy and Management, 3(4), 74–88.
93) Zajacova, A. & Lawrence, E. M. (2018). The relationship between education and health: reducing disparities through a contextual approach. Annual Review of Public Health. 3(9), 273–289.